Suleyman Tolga Yavuz1, Ersoy Civelek2, Sule Comert3, Umit Murat Sahiner4, Betul Buyuktiryaki5, Ayfer Tuncer6, Ali Fuat Kalyoncu7, Bulent Enis Sekerel8. 1. Hacettepe University, Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: styavuz@yahoo.com. 2. Hacettepe University, Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: ersoycivelek@gmail.com. 3. Hacettepe University, Faculty of Medicine, Department of Adult Allergy, 06100 Ankara, Turkey. Electronic address: sulesunmez@yahoo.com. 4. Hacettepe University, Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: umsahner@yahoo.com. 5. Hacettepe University, Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: betulbuyuktiryaki@yahoo.com. 6. Hacettepe University, Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: tuncerayfer@yahoo.com. 7. Hacettepe University, Faculty of Medicine, Department of Adult Allergy, 06100 Ankara, Turkey. Electronic address: kalyon@ada.net.tr. 8. Hacettepe University, Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: b_sekerel@yahoo.com.
Abstract
OBJECTIVES: Results of previous studies have established several factors related with the natural course of childhood asthma. The aim of this study is to investigate the prognosis of childhood asthma and to determine possible risk factors for disease persistence. METHODS: An outpatient cohort with a median (interquartile range) follow-up duration of 19.4 (17.7-21.8) years was re-evaluated. Current clinical remission (CR) was defined as no asthma symptoms and no use of controller medication within the past year. RESULTS: Out of 115 patients, 78 could be surveyed with questionnaire and 46 patients with a median age of 25.3 (23.9-27.0) years were further investigated with clinical work-up. Nineteen (24.4%) patients were in CR in both visits (adolescence and young adulthood). A further 7 patients (9.0%) who were not in CR at adolescence were in CR at the young adulthood visit. However, 21 patients (26.9%) who were in CR at adolescence were not in CR at the young adulthood visit. Thirty-one patients (39.7%) with persistent symptoms at adolescence were not in CR at young adulthood, either. In multivariate logistic models, the presence of obstructive pattern (forced expiratory volume in 1s (FEV1)/forced vital capacity (FVC) <80% vs. ≥80%) in pulmonary function tests during the adolescence period (odds ratio; [95% confidence interval] (6.71 [1.65-27.29]; p=0.008) and later-onset rhinitis (10.27 [1.18-89.13]; p=0.035) predicted the absence of CR at young adulthood. CONCLUSION: A substantial number of patients who were in CR during adolescence have re-emerging disease. The presence of obstructive pattern in adolescence and later-onset rhinitis were associated with the absence of CR in young adults with asthma. Awareness of risk factors along with early interventions may provide better results in childhood asthma.
OBJECTIVES: Results of previous studies have established several factors related with the natural course of childhood asthma. The aim of this study is to investigate the prognosis of childhood asthma and to determine possible risk factors for disease persistence. METHODS: An outpatient cohort with a median (interquartile range) follow-up duration of 19.4 (17.7-21.8) years was re-evaluated. Current clinical remission (CR) was defined as no asthma symptoms and no use of controller medication within the past year. RESULTS: Out of 115 patients, 78 could be surveyed with questionnaire and 46 patients with a median age of 25.3 (23.9-27.0) years were further investigated with clinical work-up. Nineteen (24.4%) patients were in CR in both visits (adolescence and young adulthood). A further 7 patients (9.0%) who were not in CR at adolescence were in CR at the young adulthood visit. However, 21 patients (26.9%) who were in CR at adolescence were not in CR at the young adulthood visit. Thirty-one patients (39.7%) with persistent symptoms at adolescence were not in CR at young adulthood, either. In multivariate logistic models, the presence of obstructive pattern (forced expiratory volume in 1s (FEV1)/forced vital capacity (FVC) <80% vs. ≥80%) in pulmonary function tests during the adolescence period (odds ratio; [95% confidence interval] (6.71 [1.65-27.29]; p=0.008) and later-onset rhinitis (10.27 [1.18-89.13]; p=0.035) predicted the absence of CR at young adulthood. CONCLUSION: A substantial number of patients who were in CR during adolescence have re-emerging disease. The presence of obstructive pattern in adolescence and later-onset rhinitis were associated with the absence of CR in young adults with asthma. Awareness of risk factors along with early interventions may provide better results in childhood asthma.